经皮二氧化碳气膀胱穿刺取石术联合TUVP与U100激光碎石联合TUVP治疗BPH合并膀胱结石患者的疗效比较  

A comparison between percutaneous paracentetic lithocystotomy of carbon dioxide pneumovesic combined with TUVP and U100 laser combined with TUVP for treating BPH and bladder stones

作　　者：周毅[1] 王伟[1] 李刚[1] 姚远[1] 杨剑文[1] 

机构地区：[1]广西科技大学附属柳州市人民医院泌尿外科,广西柳州545006

出　　处：《安徽医药》2014年第3期483-486,共4页Anhui Medical and Pharmaceutical Journal

基　　金：柳州市应用技术与开发计划课题(No 2011J0302029)

摘　　要：目的 探讨前列腺增生症（benign prostatic hyperplasia,BPH）合并膀胱结石的同期微创治疗方法.方法 60例患者随机分为两组,膀胱穿刺取石组（30例）采用经皮二氧化碳气膀胱穿刺取石,再行经尿道前列腺电汽化术（TUVP）.U100激光碎石组（30例）先经尿道U100激光碎石,再行TUVP.观察两组患者处理结石时间、总手术时间、前列腺切除重量、出血量、术后尿道狭窄发生率、膀胱冲洗时间、留置尿管时间、住院时间、治疗费用及术后疗效.结果 与U100激光碎石组比较,膀胱穿刺取石组术在处理结石时间上具有明显优势,两组差异有统计学意义（t=2.69,P＆lt;0.01）;在总手术时间、治疗费用也具有优势,两组差异均有统计学意义（t=2.12、8.05,均P＆lt;0.05）.两组患者均一次碎石取石成功.术后随访3～24个月,未见结石复发、尿失禁等并发症,国际前列腺症状评分（IPSS）、最大尿流率（Qmax）和残余尿量较术前均有显著改善.结论 经皮二氧化碳气膀胱穿刺取石术联合TUVP可对BPH合并膀胱结石同时处理,手术时间短,结石清除率高,疗效确切,值得临床推广.Objective To compare two means of simultaneous minimally invasive treatment for benign prostatic hyperplasia( BPH) and bladder stones. Methods Sixty cases of BHP and bladder stones were randomly assigned into 2 groups,respectively treated by percutaneous paracentetic lithocystotomy of CO2pneumovesic( Group A,30 patients) and U100 laser through urethra( Group B,30 patients),followed by TUVP after the removal of stone. The stone removal time,total operation time,resected tissue of prostate,bleeding volume,postoperative occurrence rates of urethral stricture,bladder irrigation time,catheterization time,hospital stay,hospital expenses and postoperative effects were surveyed. Results Compared with group B,the stone removal time was significantly shorter in group A( t =2. 69,P <0. 01). The total operation time and cost were also significantly superior in group A( t = 2. 12,8. 05,P < 0. 05). The procedures were successful in all cases. A follow up of 3 to 24 months found a good outcome in both groups,and no recurrent signs and severe complication like urinary incontinence were found. IPSS,Qmax and RUV were significantly improved in both groups. Conclusions The percutaneous paracentetic lithocystotomy of CO2pneumovesic combined with TUVP for treating BPH and bladder stones have the advantages of less operation time,high stone clearance rate and obvious curative effect,which is worthy of clinical promotion.

关 键 词：CO2气膀胱 膀胱结石 经尿道前列腺电汽化术 U100激光 

分 类 号：R699[医药卫生—泌尿科学]